Why 6 medical bills made headlines this year

From a $54,000 charge for a single COVID-19 test to parents receiving a $270,951 medical bill after the birth of their first child because of the "birthday rule," here are six medical bills that have made headlines this year. 

1. A patient who went to the emergency room at Emory Decatur (Ga.) Hospital said she was billed $688 for the trip even though she didn't receive treatment or leave the waiting room. Taylor Davis said she went to the ER in July for a head injury. After waiting seven hours in the waiting room without being called back, Ms. Davis said she left. A few weeks later, she received a bill for the ER trip.

2. A nearly $240,000 air ambulance bil made headlines in October after a lawsuit was filed. The lawsuit out of Florida is challenging Anthem's decision not to cover the ambulance trip, despite the patient's physician deeming it medically necessary. According to the lawsuit, Anthem suggested that the patient, who was suffering a myocardial infarction while on a cruise, receive emergency treatment at a local Dominican Republic hospital instead of a level 1 trauma center in Florida as recommended by the patient's physician.

3. A $56,384 bill made headlines in September because the bill included a $54,000 charge for a PCR COVID-19 test. A patient went to SignatureCare Emergency Center in Lewisville, Texas, to get tested for COVID-19 after one of his colleagues tested positive for COVID-19 in June 2020. The total bill was $56,384, including a $54,000 charge for the PCR test, $600 for an antigen test and $1,784 for an ER facility fee. Although Mr. Warner was not on the hook for the bill, because Congress passed laws that required insurers to pay for COVID-19 testing without copays or cost-sharing for the patient, health experts called the charge "one of the most egregious" they've seen, according to the report.

4. In September, The New York Times published a highly-shared article detailing the $257,000 medical bill two new parents in New York received after the hospital stay for their newborn, who died when she was 25 days old. Cigna said the couple owed more than $257,000 for the bills it accidentally covered for the newborn's care after her mother switched health plans. 

"For them, it's just business, but for us it means constantly going through the trauma of reliving our daughter's death," Clayton Lane, the newborn's father, told The New York Times.

5. In July, a $60 hospital bill from 1955 garnered attention online. The bill, which went viral on Reddit, was from a birth and a three-night stay in December 1955 in Belleville Hospital in Kansas. The post was upvoted more than 10,000 times, prompting new parents to share the bills they have received, which often totaled upward of $100,000.

6. In January, a Kansas couple shared the story of how they received a $270,951 medical bill after the birth of their first child — even though they're both insured. The reason for the bill is a little-known rule that stipulates a child born with double health insurance eligibility must be enrolled in the plan belonging to the parent whose birthday comes first in the calendar year. 

This regulation, known as the "birthday rule," determines which insurance will be primary for the child and which will be secondary, but premiums, deductibles and networks often vary greatly between both parents' insurance plans, so parents don't always have the option to make the more comprehensive plan their child's primary insurance.

 

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